1/17/2024 0 Comments Vertebral meaning![]() ![]() For example, one may have total spine imaging or correlation with prior imaging to allow numbering from C1/2. Although the ligament seems to always arise from the last lumbar vertebra, the accuracy of this method has been questioned in cases of lumbosacral transitional anatomy 5,6.ĭespite classification systems, nothing replaces an explicit description of what nomenclature has been used and assumptions made in cases where the anatomy is non-standard. The iliolumbar ligament is an alternative landmark on which to base numbering (see case 4) as it usually arises from the transverse process of L5 1. 6 lumbar segments (25 presacral vertebrae, completely lumbarized S1): two nerves of similar caliber at the lateral sacrum represent the L5 and S1 nerves.5 lumbar segments (24 presacral vertebrae with normal anatomy, partial L5 sacralization, or partial S1 lumbarization): a thin nerve joining a thicker nerve at the lateral sacrum represents the peroneal branch of L4 and the L5 nerve.4 lumbar segments (23 presacral vertebrae with completely sacralized L5): a bundle of several splitting nerves at the lateral sacrum represents the L4 nerve.Numbering can also be ascertained on axial MRI images (see case 9) at the sacral level using nerve morphology given that the L5 nerve characteristically does not split proximally and has twice the caliber of the L4 peroneal branch at this level 5. However, these are often not part of lumbar spine MRI protocols. The most accurate method of enumerating the vertebrae requires taking localizer sequences of the entire spine to count down from C2. The Castellvi classification is commonly used to classify transitional anatomy.įerguson projection (AP lumbar spine radiograph, 30° cranial tilt) and lateral projection have been traditionally used as the best method for identification of lumbosacral transitional vertebra, although this has been largely replaced by cross-sectional imaging. hypoplastic or absent facet joints or intervertebral disc at L5-S1. ![]() broadened transverse processes, potentially with pseudoarticulation or fusion with one or both sacral ala.wedging of the lowest lumbar (transitional) vertebral body. ![]()
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